Children and Sun Safety

A single blistering sunburn in childhood or adolescence doubles a person's chances of developing melanoma skin cancer later in life.  Other types of skin cancer, basal cell carcinoma and squamous cell carcinoma, are directly related to long-term sun exposure.  Children often spend a good part of their day playing outdoors in the sun, especially during the summer.  The development of skin cancer, as well as premature skin aging and eye damage, are reasons that measures to protect the body from harmful sun rays should be started early in life.
What is sunburn?  Sunburn is a reaction to skin exposure to ultraviolet (UV) radiation which are the invisible rays that are part of sunlight.  Sunlight contains three types of ultraviolet rays: UVA, UVB, and UVC. UVA rays make up the majority of our sun exposure since they freely pass through the ozone layer.  UVB rays are blocked to a large degree by the ozone layer, but most cases of sunburn, as well as the development of melanoma, are due to excessive exposure to UVB radiation.  UVC rays are more dangerous than the other two types but, fortunately, are blocked from reaching the earth by the ozone layer.

How well do sunscreens work?  Sunscreens contain chemicals that help prevent ultraviolet (UV) radiation from reaching the skin.  There are a number of effective sunscreens on the market. The best sunscreens provide "broad spectrum" coverage, meaning that they block both UVA and UVB rays.  When shopping, you should look for sunscreen with a Sun Protection Factor (SPF) of 15 or higher.  SPF indicates how long it will take for UVB rays to redden skin when using a sunscreen, compared to how long skin would take to redden without the product.  Sunscreen should be applied even on cloudy days since UV rays can penetrate clouds.

How should sunscreen be applied?  The chemicals in sunscreens have caused skin reactions in some children.  It is best to test a small area of the skin before applying them to the entire body.  The appropriate application and re-application of sunscreen is equally important as its SPF rating.  Sunscreen should be applied liberally at least 20 to 30 minutes before exposure to the sun, making sure that exposed areas are well covered, and rubbed in completely.  As a guide, the appropriate amount for an adult-sized body is approximately one ounce (the amount in shot glass).  Keep in mind that no sunscreens are truly waterproof, and need to be reapplied every one and a half to two hours, particularly if the child spends a lot of time in the water.  In children who are prone to sunburn, use sunscreen with a higher SPF rating, although there is little additional benefit in using one higher that 50+.  For maximum protection against UV rays, particularly on highly sensitive areas such as the nose or tops of ears, a sunblock may be preferable to sunscreen.  These contain physical agents, such as titanium dioxide or zinc oxide that completely absorb UV rays.  Sunblocks remain opaque on the skin and some even come in colors that kids enjoy.

Besides sunscreen, what can be done to avoid sunburn?  The American Academy of Pediatrics (AAP) recommends that babies younger than 6 months of age should be kept out of direct sunlight.  When possible find shade under a tee, umbrella, or the stroller canopy to shade the infant.  If adequate clothing and shade are not available, sunscreen can be used on small areas of an infant's body, such as the face and the backs of the hands.  For children over the age of 6 moths the AAP offers the following recommendations to avoid sunburn in children:

• Select clothes made with a tight weave - they protect better than clothes with a looser weave.  If you're not sure how tight a fabric's weave is, hold it up to see how much light shines through.  The less light, the better.
• Wear a hat or cap with a brim that faces forward to shield the face.
• Limit sun exposure between 10:00 am and 4:00 pm, when UV rays are strongest.
• Set a good example. You can be the best teacher by practicing sun protection yourself.

What about eye protection from the sun???  UV radiation can be damaging to the eyes as well as the skin.  Cataracts, skin cancer, and a benign growth on the surface of the eye known as a pterygium have all be associated to excessive UV exposure.  Sunglasses rated to block 99 to 100 percent of both UVA and UVB will offer protection against these conditions.  Sunglasses should be sized appropriately for the child's face.  A wide-brimmed hat will also help to reduce the amount of UV radiation that reaches the eyes.

Are tanning booths a safer alternative to "laying out" in the sun?  Absolutely not! The bulbs in tanning booth can produce over 10 times as much UVA radiation as the sun.  Studies have shown that people who use tanning booth have a higher rate of occurrence of squamous cell and basal cell carcinoma as well as skin melanoma.  Several authorities have advocated making it illegal for parents to let kids under 18 use tanning booths.  The bottom line is that there is no such thing as a "healthy tan".  Whether it came from a tanning booth or from sun exposure, tans are the result of exposure to harmful UV radiation on the skin.